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COVID-19 Health Care Provider Briefing Middlesex and London Region September 29, 2020
Welcome Presenter: Dr. Alex Summers Associate Medical Officer of Health Middlesex-London Health Unit @alexsummers4
Surveillance Report As of September 21 st , 2020: • Over 33.4 million COVID-19 cases and over 1 million deaths have been reported worldwide. • 50,531 cases of this illness confirmed in Ontario, including 2,840 deaths • Local:
Cases by Reported Date Data source : MLHU COVID-19 Case and Contact Management System, extracted 2020-09-29 at 08:30 EDT. Data current as of the end of day 2020-09-28
Cases by Onset Date Data source : MLHU COVID-19 Case and Contact Management System, extracted 2020-09-29 at 08:30 EDT. Data current as of the end of day 2020-09-28 Note : Illness that began in the period denoted by the grey bars may not yet be reported.
Provincial Updates • invest $1.07 billion for COVID-19 testing and contract tracing, • specific pharmacies in Ontario will soon provide COVID-19 testing for asymptomatic people that meet the following criteria: o are a contact of a confirmed positive case o live or work in an at-risk setting, such as a long-term care home, homeless shelter or other congregate setting o will be visiting a long-term care home o are a worker or resident of a specific outbreak site, including a long-term care home, retirement home or school o are eligible for testing as part of a targeted testing initiative as determined by the Ministry of Health or Ministry of Long-term Care.
Provincial Updates Effective September 26 th : • restaurants, bars and other food and drink establishments (including nightclubs) are prohibited from selling alcohol after 11:00 p.m., having alcohol consumed on the premises between 12:00 a.m. and 9:00 a.m., and will be required to close by 12:00 a.m., • all strip clubs are closed, • businesses and/or organizations are required to comply with any advice, recommendations, and instructions issued by the Office of the Chief Medical Officer of Health related to screening for COVID- 19, including screening patrons and other individuals who wish to enter their premises.
Provincial Guidance Documents • The Ontario government: – New: Covid-19 Screening Tool for Workplaces (Businesses and Organizations) – Updated: COVID-19 Testing Guidance, includes: • Added indications for influenza testing • Updated guidance on asymptomatic testing • Updated guidance on facility transfers for newborn infants • Updated guidance on testing asymptomatic cancer patients and hemodialysis patients – Updated: COVID-19 Guidance: Mental Health and Addictions Service Providers in Community Settings
PHO Influenza Resources • Public Health Ontario has released: – Influenza Vaccines for the 2020 – 2021 Influenza Season – Influenza Antiviral Treatment – Antiviral Medication Use During an Influenza Outbreak: Congregate Living Settings – PHO Grand Rounds: The 2020-21 Influenza Season - Hope for the best, plan for the worst (Repeat presentation) – Interactive Report: Ontario Respiratory Pathogen Bulletin
Ontario Medical Association Survey The OMA has developed a survey to determine the barriers, supports, and ideas physicians are leading or participating in for the 2020/2021 influenza season. The survey will be available until October 7 th .
Local Update • School: – A new COVID-19 FAQ for Parents of School-aged Children has been released by the Children’s Hospital London Health Sciences Centre, Southwestern Public Health, and the Middlesex London Health Unit. • Assessment Centres – To find the latest wait times at London's COVID-19 Assessment Centres, please visit the Thames Valley Family Health Team on Twitter @ThamesValleyFHT • Pathology and Laboratory Medicine (PaLM) – Updated guidance on who to test, sample collection, testing algorithms
Local Update • Long-term care homes (LTCHs) and retirement homes (RHs) – Here’s how to reach the IDC Team, seven days a week between 8:30 a.m. and 9:00 p.m.: • Monday to Friday from 8:30 a.m. to 4:30 p.m., please call 519-663-5317 • Monday to Friday from 4:30 p.m. to 9:00 p.m. and on weekends, please call 519-663-5317 and enter extension 9012, for urgent COVID-19 related matters, such as a concern with a symptomatic resident, or a positive case of COVID-19.
Education/Resources • Public Health Ontario has released the following documents: – New: Checklist COVID-19 Preparedness and Prevention in Elementary and Secondary (K-12) Schools – New: Adverse Childhood Experiences (ACEs) – Updated: Bacterial Infections in Hospitalized COVID-19 Patients – What We Know So Far – Updated: Long-Term Sequelae and COVID-19 – What We Know So Far – Updated: COVID-19 – What We Know So Far About… the Risks to Health Care Workers – Updated: Infection Prevention and Control (IPAC) Environmental Services (ES) Webinar – Updated: How to Protect Yourself from COVID-19: Older Adults and People with Chronic Medical Conditions or Weakened Immune Systems
Questions from last week • In planning for the upcoming flu season we are considering running outdoor flu shot clinics. What is the official recommendation on having people wait around after their shot in that context or even in the office, can we let them leave immediately to avoid congestion? • Anonymous: Since the government has funded nurses in the schools would it not make sense to have another option for parents such as having the funded public health nurses do the swabs at school? The feedback we are getting from parents is that this would be preferred. Are nurses being assigned to certain schools? What other options do parents have for testing? Will you be offering testing at the health unit? Have you considered drive through testing at the assessment centres? My second question ( if you have time) is re flu shot clinics. What are your suggestions in terms of running clinics this year?
Questions from last week • This question is about how can we expand COVID testing capacity in primary care? I am a family physician at a community health centre. Yesterday a family in my practice came for what was supposed to be a routine apt. They are recent arrivals to Canada and do not speak English, single mom and 4 children. Mom and one child had rhinitis, cough, and mild SOB. Physical exam was normal. Even though they were minimally symptomatic they were scared. Scared about COVID but also the mom was worried about keeping the children out of school. Since we have adequate PPE at our office I put them in our hot room, examined them, and did COVID swabs. The entire encounter took 15 minutes. Luckily they came in before lifelabs came for their daily pick up for PAPs and other investigations so I was able to send the COVID swabs off immediately at no extra effort or expense to our clinic. This was a very satisfying clinical encounter for me.
Questions from last week • Anonymous 12:02 PM Is there a plan for people at the assessment centres who are more vulnerable and don't have a car? • Anonymous 12:09 PM any plans to add more assessment centres? Patients are not going to get tested if they have to wait >6 hours or get turned away (which happened to my nurse yesterday). Thank you! • Anonymous 12:14 PM Is the assessment center capacity limited due to available swabs or staff? Are there enough swabs for us to be swabbing patients in our clinics or should we be rationing those? • Anonymous 12:15 PM How quickly does one get infected with covid 19. If I was exposed today and got swabbed 5 hours later would the covid test return positive or negative? Do we even know this information?
Questions from last week • Anonymous 12:16 PM If we (family dr) are bringing people in for patients, what PPE/protocol do we have to use as they enter the building, if we can't do a parking lot assessment? (eg. coming up stairs/elevator) - is patient wearing a mask sufficient? • Anonymous 12:20 PM There seems to be inconsistent recommendations among several health units. What do we do with siblings of children who have symptoms of covid 19? the sick child goes for testing do the children in the house all have to isolate until the test results? what about the parents who are asymptomatic? Are they required to isolate also? • Is there anything in the works to help support families obtain testing for failed school screening? It is very difficult to wait at the Assessment Centers for 5+ hours with young children. sick child goes for testing do the children in the house all have to isolate until the test results? what about the parents who are asymptomatic? Are they required to isolate also?
MLHU Info and Contact • Weekly webinars held on Tuesdays at 12:00 p.m. to 12:30 p.m. • Please send your questions to healthcareproviders@mlhu.on.ca • Monday to Sunday, 8:00 a.m. - 7:00 p.m. – Hotline model – Call 519-663-5317 • www.healthunit.com
Questions? Ask using chat function now, or after the webinar at: healthcareproviders@mlhu.on.ca
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